ESTRO 36 Abstract Book

764 / 1082

S748 ESTRO 36 2017
_______________________________________________________________________________________________
or within 30 days of targeted/immunotherapy, reporting
severe (≥Grade 3) toxicity were included.
Results
A total of 49 studies were included. Of these, 13 (321
patients) were prospective studies, 27 (653 patients)
retrospective studies and 9 (16 patients) case reports. The
number of patients per study ranged from 1 to 106
(median 15). Targeted agents concurrent with cranial SRT
were tested in 34 studies and with extra-cranial SRT in 19
studies. For cranial SRT, severe toxicity was observed in
14% (89/644) of patients, for extra-cranial SRT in 16%
(84/524). Severe toxicity possibly related to cranial SRT or
extra-cranial SRT was observed in 6% (5.4% Gr3; 0.6% Gr4;
0% Gr5) and 9% (7.6% Gr3; 0.8% Gr4; 0.6% Gr5),
respectively. Overall, concurrent cranial SRT was well
tolerated, except when combined with BRAF-inhibitors
(severe toxicity in 20/75 patients (27%)). Furthermore,
there is a high risk of morbidity when extra-cranial SRT is
combined with EGFR-targeting tyrosine kinase inhibitors
and bevacizumab, which was not observed after cranial
SRT.
Conclusion
The currently available information concerning toxicity
after concurrent SRT and targeted/immunotherapy is
limited. The focus of published studies lies mainly on
concurrent cranial SRT, where the combination generally
is well tolerated. For extra-cranial SRT, no definitive
conclusions can be drawn. This review underlines the need
for clinical studies testing the combination of SRT and
targeted drugs/immune check point Inhibitors.
EP-1415 Interventions to Address Sexual Problems in
People with Cancer
L. Barbera1, C. Zwaal 2, D. Elterman3, W. Wolfman4, A.
Katz5, K. McPherson6, A. Matthew7
1 Odette Cancer Centre - Sunnybrook Health Sciences
Centre, Radiation Oncology, North York- Toronto,
Canada
2 McMaster University, Oncology, Hamilton, Canada
3 University Health Network, Urology, Toronto, Canada
4 Mount Sinai Hospital, Obstetrics and Gynecology,
Toronto, Canada
5 CancerCare Manitoba, Cancer and Sexuality Counselling,
Winnipeg, Canada
6 Cancer Care Ontario, Patient and Familty Advisory
Council, Toronto, Canada
7 University Health Network, Surgical Oncology, Toronto,
Canada
Purpose or Objective
Objective: Sexual dysfunction in people with cancer is a
significant problem. This guideline aimed to address the
following question: “What is the effectiveness of
pharmacologic interventions, psychosocial counselling or
devices to manage sexual problems after cancer
treatment?”
Material and Methods
Methods: This guideline was created with the support of
the Program in Evidence-Based Care. We searched for
existing systematic reviews, guidelines and relevant
primary literature from 2003-2015. Men and women were
evaluated separately. No restrictions were made on
cancer type or study design. When first approaching the
guideline the working group chose to focus on sexual
disorders commonly known to arise in people with cancer.
These included decreased desire, arousal disorders, pain
(in women) and erectile dysfunction (in men). Only studies
that evaluated the impact of an intervention on a sexual
function outcome were included.
Results
Results: The panel made one overarching recommendation
that there be a discussion with the patient, initiated by a
member of the health care team, regarding sexual health
and dysfunction resulting from the cancer or its
treatment. The Expert Panel felt that this is vital since the
additional recommendations cannot be used unless
someone has taken the initiative to ask. There were
numerous limitations of the existing literature. However,
we made additional recommendations on 11 outcomes: 6
for women (sexual response, body image,
intimacy/relationships, overall sexual
function/satisfaction, vasomotor symptoms, genital
symptoms) and 5 for men (sexual response, genital
changes, intimacy/relationships, overall sexual
function/satisfaction, vasomotor symptoms). There is a
role for medication or devices in particular
circumstances. Psychosocial counselling however had the
largest evidentiary base for most of the outcomes.
Conclusion
Conclusion: To our knowledge this is the first evidence
based guideline to comprehensively evaluate
interventions to improve sexual problems in people with
cancer. The guideline will be a valuable resource to
support practitioners and clinics in addressing this
important aspect of being human.
EP-1416 A new model of care to improve clinical trial
participation in radiation oncology
M. Grand1,2,3, M. Berry1,3,4, D. Forstner1,3,4, S. Gillman1,3,
P. Phan1,3, K. Wong1,4,5, S. Vinod1,4,6
1Liverpool Hospital, Cancer Therapy Centre, Liverpool,
Australia
2Ingham Institute for Applied Medical Research, Clinical
Trials, Liverpool- NSW, Australia
3Campbelltown Hospital, Cancer Therapy Centre,
Campbelltown- NSW, Australia
4University of NSW, South Western Sydney Clinical
School, NSW, Australia
5Ingham Institute for Applied Medical Research, CCORE,
Liverpool- NSW, Australia
6Western Sydney University, Clinical School, NSW,
Australia
Purpose or Objective
Clinical trial participation is becoming increasingly
recognised as an indicator of quality of care in
oncology. Previously, Radiation Oncology (RO) clinical
trials at Liverpool and Macarthur Cancer Therapy Centres,
Sydney, Australia were managed by a general oncology
clinical trials unit. The focus was largely on
pharmaceutical and large collaborative group trials, and
less on investigator initiated studies. This model was
heavily reliant on individual clinicians remembering to
screen and recruit patients. Recognising our low rates of
participation in clinical trials, we decided to develop and
implement a new model of care to support clinical trials
in RO.
Material and Methods
A new team dedicated to RO clinical trials with specific
skill sets in nursing, radiation therapy and clinical
research, was formed in December 2014. Strategies
were devised to improve performance which included
development of standard operating procedures, Good
Clinical Practice (GCP) training, and active education and
communication. Work processes were changed to be less
reliant on clinicians, with more co-ordination by the RO
clinical trials team. Active screening was conducted
through attendance at multidisciplinary team meetings,
screening clinic lists and development of a MOSAIQ
screening tool for clinicians. The model involved regular
auditing and feedback to clinicians to identify poor
recruiters or poorly recruiting trials, and provide clinical
trials support to improve this.
Results
Across both Liverpool and Macarthur Cancer Therapy
Centres, screening activity increased from 51 patients
screened in 2014, to 339 in 2015, and to 487 up to August
2016. Participation in clinical trials, as a percentage of
new patients seen in RO clinics, increased from 2.6% in
2014, to 12.4% as of August 2016 (Fig 1). The number of